Baby, Infant health

Sucking confusion in babies: causes, symptoms & prevention

Sucking confusion in babies: causes, symptoms & prevention

Your baby refuses the breast and cries? It only sucks for a short time and then stops again? It is possible that this is due to suction confusion.

If your baby is very restless when breastfeeding or even refuses the breast completely, suction confusion could be the possible cause. If babies are offered pacifiers for newborns and bottles in addition to the breast during the first weeks of life, this phenomenon can occur. The many different aids “confuse” the baby’s sucking reflex, so to speak. Find out here how you can remedy sucking confusion.

sucking reflex in the baby

Babies are equipped with various reflexes when they are born . These innate reflexes are carried out instinctively when there is a corresponding stimulus and serve to protect oneself. One of the most important reflexes is the baby’s “sucking reflex”. A baby usually instinctively seeks its mother’s breast a few moments after birth. The sense of smell and touch helps the baby to find the breast and to start sucking.

However, experts believe that sucking or emptying the breast effectively is a technique that takes time for babies to learn and perfect. Experts are also discussing whether switching between the breast and artificial teats such as pacifiers or bottles at the beginning of the breastfeeding relationship can lead to the child not learning properly or forgetting to suckle from the breast. However, there are still few meaningful studies on this topic.

A baby has to do everything when breastfeeding

When infants suckle at the breast, it gives a truly peaceful picture. But in reality, the little ones are very busy right now and are performing at their best to get their mother’s milk . Sucking process, tongue and mouth position, the synchronous interaction of lips, jaw, tongue and palate – all of this has to be right.

What Babies Do When Breastfeeding:

  1. The baby first opens its mouth wide to get the nipple and part of the areola in the mouth.
  2. Now the wart is sucked in vigorously until a vacuum is created.
  3. The baby is now “chewing” with its tooth ridges to stimulate the flow of milk.
  4. Then it swallows the milk.
  5. In all this, of course, breathing must not be forgotten.

Quite a complex process, isn’t it? No wonder that breastfeeding in particular can be “prone to failure” in some areas and sometimes there is a so-called nipple confusion.

Sucking Confusion: Definition

Especially in the first weeks of a baby’s life, the learning process of correct sucking is very prone to failure. If the little one is offered too many other sucking aids (bottle, pacifier for newborns) in addition to the breast during this time, this can quickly “confuse” the baby’s sucking reflex. After all, sucking on the bottle is much easier than sucking on the breast. There is no need to create a vacuum, the baby just has to open his mouth slightly and the milk flows into his mouth without having to suckle.

So if the little one is often offered pacifiers for newborns and bottles in the first few weeks of life, even before it has learned to suck the nipple properly, the sucking reflex can atrophy – sucking confusion arises. Due to the atrophied reflex, the breast milk no longer flows at all or only very weakly, which extremely frustrates the little one. It soon turns into a “chest strike”.

However, suction confusion is not always the cause of a strike. Sometimes children simply do not have the strength to suck on the nipple, for example because they are tired or have just been weakened by an illness . Some days the little ones just don’t like the breast milk.

Causes of suction confusion

If various aids such as pacifiers and the like are used too early, too often and in alternation, this can cause suction confusion. Here you can see the causes again at a glance:

  • Pacifiers for newborns
  • Bottle teat/pacifier/Nipple shield
  • Improper attachment to the breast
  • Baby has already trained itself out of the sucking reflex in the womb because it sucked on fingers and thumbs


Signs of suction confusion

But how do you know if your baby has problems breastfeeding or if his sucking reflex is confused? These signs indicate a suction confusion:

  • Your baby is refusing the breast and crying more and more often.
  • Your little one is very restless when breastfeeding.
  • The child sucks only briefly and stops again.
  • Your little one sucks on the nipple but doesn’t swallow because she can’t get any milk out.
  • You hear your baby smacking instead of swallowing.
  • You notice that your baby keeps losing the nipple.
  • It almost looks like your baby is sucking on a straw.

But you can also tell from yourself whether your baby has a sucking confusion:

  • You have a feeling of tightness in your breasts, which may indicate engorgement
  • You have sore nipples
  • The chest does not feel empty and soft

Fixing Suction Confusion: What Can I Do?

In order to be able to breastfeed your baby without any problems , you should leave no stone unturned. The most important rule is: stay calm and patient. If it still doesn’t work out, then don’t put yourself under any pressure. There is no guarantee that a baby will learn to suck properly.

These tips can often resolve suction confusion:

  • Do not bottle feed
  • Do not give your baby a pacifier or a soother
  • Place the baby exactly on the breast and pay attention to the correct breastfeeding position
  • Try breastfeeding when your child is half asleep, it will be less defensive
  • In addition to the nipple, the child must also take the areola into the mouth
  • Stimulate your nipple beforehand to facilitate milk flow
  • Close physical contact and a few drops of milk have a calming effect on your baby

WHO recommendation

The World Health Organization (WHO) and many midwives recommend that a mother should exclusively breastfeed during the first six months of life and avoid using aids such as pacifiers or bottles. This tip often prevents suction confusion. Numerous studies have now also shown that breastfeeding makes you smart. For example, researchers have found that breastfeeding increases children’s cognitive abilities and often leads to better school performance.


Eliminating any suction confusion is therefore worthwhile in many respects as far as the child’s development is concerned. However, such results can of course also put some pressure on mothers who, for certain reasons, cannot breastfeed. Here it is important to know: Of course breastfeeding is a great thing, but it is far from the only factor that affects intelligence and cognitive abilities.

Correct nipple sucking can be very prone to failure and other problems can arise that sometimes make aids unavoidable. So don’t be too strict with yourself! It’s great when it works without tools and otherwise you shouldn’t put yourself under too much pressure.

Don’t take breast refusal personally

If your child goes on breastfeeding strike due to nipple confusion, fatigue, or illness, don’t take it personally. It is often difficult for a mother to bear when the child suddenly refuses the breast, but it has absolutely nothing to do with you. Don’t see your baby’s behavior as a rejection of you. It has something against breastfeeding at this moment – after all, it’s very exhausting – but of course not against you. Babies are so-called “displeasure avoiders” and often choose the path of least resistance – in this case the bottle. As the name suggests, it’s just a confusion that can often be rectified.


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